CAADC Evidence-Based Counseling Models 4 — Questions and Answers
Question 1: In Acceptance and Commitment Therapy (ACT), the concept of 'psychological flexibility' refers to:
- Adapting treatment plans based on client feedback
- The ability to contact the present moment and change or persist in behavior that serves valued ends (Correct answer)
- Flexibility in scheduling sessions to improve attendance
- Using multiple therapeutic modalities simultaneously
Correct answer: The ability to contact the present moment and change or persist in behavior that serves valued ends
Psychological flexibility in ACT means being able to be fully present and act according to one's values, even in the presence of difficult thoughts and feelings.
Question 2: The 'Network Therapy' approach for substance use disorders primarily involves:
- Online peer support communities
- Engaging the client's social network (family, friends) as active supports in treatment (Correct answer)
- A network of multiple therapists collaborating on one case
- Connecting clients to community recovery resources only
Correct answer: Engaging the client's social network (family, friends) as active supports in treatment
Network Therapy recruits the client's social network as active participants who attend sessions and help support abstinence goals.
Question 3: Which component of Dialectical Behavior Therapy (DBT) specifically addresses interpersonal effectiveness skills for clients with co-occurring addiction?
- Distress tolerance module
- Mindfulness module
- Interpersonal effectiveness module (Correct answer)
- Emotion regulation module
Correct answer: Interpersonal effectiveness module
The interpersonal effectiveness module teaches skills for maintaining relationships, setting limits, and asking for what one needs — critical areas often impaired by addiction.
Question 4: A counselor using the Community Reinforcement Approach (CRA) would MOST likely:
- Focus exclusively on 12-step facilitation techniques
- Restructure the client's environment to make sobriety more rewarding than substance use (Correct answer)
- Use aversive conditioning to reduce cravings
- Prioritize insight-oriented techniques from psychodynamic theory
Correct answer: Restructure the client's environment to make sobriety more rewarding than substance use
CRA systematically rearranges environmental contingencies so that sober activities and relationships compete favorably with substance use.
Question 5: In evidence-based practice, a 'functional analysis' of substance use behavior is designed to:
- Assess the client's functional impairment level for diagnostic purposes
- Identify the antecedents, behaviors, and consequences that maintain use (Correct answer)
- Evaluate whether the client can function in outpatient versus inpatient care
- Measure cognitive functioning before and after treatment
Correct answer: Identify the antecedents, behaviors, and consequences that maintain use
Functional analysis (ABC analysis) maps out triggers, the use behavior itself, and its reinforcing consequences to inform individualized intervention.
Question 6: The 'voucher-based reinforcement' component used in Contingency Management provides incentives that are:
- Given immediately contingent on verified drug-negative urine samples (Correct answer)
- Awarded at the end of each month based on overall progress
- Provided only after 90 days of sustained abstinence
- Determined by the client's self-report of abstinence
Correct answer: Given immediately contingent on verified drug-negative urine samples
Voucher-based CM relies on immediate, objective reinforcement (verified by urinalysis) to strengthen abstinent behavior through operant conditioning.
Question 7: When applying Cognitive-Behavioral Therapy (CBT) for relapse prevention, 'coping self-efficacy' refers to a client's:
- Belief in their ability to handle high-risk situations without using substances (Correct answer)
- General self-esteem and confidence in daily life
- Trust in the therapeutic relationship to support recovery
- Ability to accurately self-monitor their own substance use
Correct answer: Belief in their ability to handle high-risk situations without using substances
Coping self-efficacy, a key CBT construct from Marlatt's relapse prevention model, is the client's confidence in using coping skills to manage high-risk situations.
CAADC Evidence-Based Counseling Models 4
In Acceptance and Commitment Therapy (ACT), the concept of 'psychological flexibility' refers to: